Trocar vs. Seldinger small bore pleural drains: does the technique influence the outcomes? A prospective single-centre study

OBJECTIVE: The aim of this study is to compare two positioning techniques of 12-French (Fr) thoracic drains in terms of effi- cacy, safety, and patient comfort. PATIENTS AND METHODS: This is a pro-spective, non-randomized, competitive, non -in-feriority study comparing the Seldinger vs. Tro-car technique. The primary endpoint was an analysis of the factors that led to unsuccessful drainage positioning. Between the two groups, clinical variables, procedure times, pain, and complications were compared. RESULTS: Seventy-two patients were enrolled in group 1 (Seldinger) and 45 in group 2 (Tro-car). The mean procedural time was 7.93 +/- 3.02 min vs. 7.09 +/- 3.67 min, respectively (p: 0.33). The mean VAS for procedural pain was 2.22 +/- 1.47 vs. 2.80 +/- 1.88, p: 0.07, and the mean at day 2 was 3.6 +/- 1.2 in the SBWGD group vs. 2.7 +/- 1.1 in the Unico Group (p: 0.04). There was no difference in terms of complications, residual effusion, and pneumothorax at the first post-procedural chest X-ray. Four days after the procedure, the drain removal rate was 11.6% in group 1 vs. 25% in group 2 p: 0.063). The chest tube was removed after a mean period of 8.87 +/- 7.20 days after res-olution of pleural effusion or tube dislodgement (7 cases in group 1 vs. 11 in group 2, p: 0.053). CONCLUSIONS: The two techniques resulted in comparable pain and complication rates. Both drains are well-tolerated and efficient at draining pleural effusion, with very low rates of complica-tions and failure. We recommend inserting a lon-ger tube for patients who require chest drainage for an extended period of time.

Automated summary

This study compared two positioning techniques for 12-French (Fr) thoracic drains in terms of efficacy, safety, and patient comfort. The results showed comparable pain and complication rates for both techniques, with efficient drainage of pleural effusion. It is recommended to use a longer tube for patients who require chest drainage for an extended period of time.